Healthcare Provider Details

I. General information

NPI: 1326485509
Provider Name (Legal Business Name): ANESTHESIOLOGY PRACTICE ASSISTANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 N MAIN AVE 1023
SAN ANTONIO TX
78212-4723
US

IV. Provider business mailing address

3702 BLACKSTONE RUN
SAN ANTONIO TX
78259-2750
US

V. Phone/Fax

Practice location:
  • Phone: 210-212-8280
  • Fax: 210-212-8589
Mailing address:
  • Phone: 210-223-1181
  • Fax: 210-226-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO T AVILA I
Title or Position: OWNER/PROVIDER
Credential: M.D.
Phone: 210-212-8280